Mechanism and treatment of portal-systemic circulatory imbalance in hepatorenal syndrome

Lihong YANG; Jinhui YANG

doi:10.3969/j.issn.1001-5256.2021.12.006

Volume 37 Issue 12

Dec. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(12): 2770-2773

PDF( 1874 KB)

Mechanism and treatment of portal-systemic circulatory imbalance in hepatorenal syndrome

DOI: 10.3969/j.issn.1001-5256.2021.12.006

Lihong YANG,
Jinhui YANG^,

Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China

Received Date: 2021-08-04
Accepted Date: 2021-08-04
Published Date: 2021-12-20

Abstract

Abstract

Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, and its pathogenesis is associated with the systemic hemodynamic changes such as portal hypertension, arterial vasodilation, reduced cardiac output, reduced effective circulating blood volume, and renal artery contraction, as well as portal-systemic circulatory imbalance. For the treatment of HRS at present, vasoactive agents and interventional treatment are used to change systemic hemodynamics and portal-systemic circulatory imbalance, and early intervention can improve the prognosis of patients.
- Hepatorenal Syndrome,
- Portal Hypertension,
- Blood Circulatione,
- Therapeutics

FullText(HTML)

References(32)

References

[1]	FAGUNDES C, GINÈS P. Hepatorenal syndrome: A severe, but treatable, cause of kidney failure in cirrhosis[J]. Am J Kidney Dis, 2012, 59(6): 874-885. DOI: 10.1053/j.ajkd.2011.12.032.
[2]	ANGELI P, GARCIA-TSAO G, NADIM MK, et al. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document[J]. J Hepatol, 2019, 71(4): 811-822. DOI: 10.1016/j.jhep.2019.07.002.
[3]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of ascites and complications in cirrhosis[J]. J Clin Hepatol, 2017, 33(10): 1847-1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003. 中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 临床肝胆病杂志, 2017, 33(10): 1847-1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.
[4]	BIGGINS SW, ANGELI P, GARCIA-TSAO G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases[J]. Hepatology, 2021, 74(2): 1014-1048. DOI: 10.1002/hep.31884.
[5]	MINDIKOGLU AL, PAPPAS SC. New developments in hepatorenal syndrome[J]. Clin Gastroenterol Hepatol, 2018, 16(2): 162-177. e1. DOI: 10.1016/j.cgh.2017.05.041.
[6]	WIEST R, LAWSON M, GEUKING M. Pathological bacterial translocation in liver cirrhosis[J]. J Hepatol, 2014, 60(1): 197-209. DOI: 10.1016/j.jhep.2013.07.044.
[7]	MAIWALL R, CHANDEL SS, WANI Z, et al. SIRS at admission is a predictor of AKI development and mortality in hospitalized patients with severe alcoholic hepatitis[J]. Dig Dis Sci, 2016, 61(3): 920-929. DOI: 10.1007/s10620-015-3921-4.
[8]	KOSHY AN, FAROUQUE O, CAILES B, et al. Impaired cardiac reserve on dobutamine stress echocardiography predicts the development of hepatorenal syndrome[J]. Am J Gastroenterol, 2020, 115(3): 388-397. DOI: 10.14309/ajg.0000000000000462.
[9]	MA ZH, LEE SS. Cirrhotic cardiopulmonary: Getting to the heart of the matter[J]. Hepatology, 1996, 14: 606-608. DOI: 10.1002/hep.510240226.
[10]	BLENDIS L, WONG F. Is there a cirrhotic cardiomyopathy?[J]. Am J Gastroenterol, 2000, 95(11): 3026-3028. DOI: 10.1111/j.1572-0241.2000.03249.x.
[11]	NAM SW, LIU H, WONG JZ, et al. Cardiomyocyte apoptosis contributes to pathogenesis of cirrhotic cardiomyopathy in bile duct-ligated mice[J]. Clin Sci (Lond), 2014, 127(8): 519-526. DOI: 10.1042/CS20130642.
[12]	ALQAHTANI SA, FOUAD TR, LEE SS. Cirrhotic cardiomyopathy[J]. Semin Liver Dis, 2008, 28(1): 59-69. DOI: 10.1055/s-2008-1040321.
[13]	WARD CA, LIU H, LEE SS. Altered cellular calcium regulatory systems in a rat model of cirrhotic cardiomyopathy[J]. Gastroenterology, 2001, 121(5): 1209-1218. DOI: 10.1053/gast.2001.28653.
[14]	FEDE G, PRIVITERA G, TOMASELLI T, et al. Cardiovascular dysfunction in patients with liver cirrhosis[J]. Ann Gastroenterol, 2015, 28(1): 31-40. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.809.2150&rep=rep1&type=pdf
[15]	AMIN AA, ALABSAWY EI, JALAN R, et al. Epidemiology, pathophysiology, and management of hepatorenal syndrome[J]. Semin Nephrol, 2019, 39(1): 17-30. DOI: 10.1016/j.semnephrol.2018.10.002.
[16]	ZHANG HY, HAN DW, WANG XG, et al. Experimental study on the role of endotoxin in the development of hepatopulmonary syndrome[J]. World J Gastroenterol, 2005, 11(4): 567-572. DOI: 10.3748/wjg.v11.i4.567.
[17]	KOSTREVA DR, CASTANER A, KAMPINE JP. Reflex effects of hepatic baroreceptors on renal and cardiac sympathetic nerve activity[J]. Am J Physiol, 1980, 238(5): R390-R394. DOI: 10.1152/ajpregu.1980.238.5.R390.
[18]	MING Z, SMYTH DD, LAUTT WW. Decreases in portal flow trigger a hepatorenal reflex to inhibit renal sodium and water excretion in rats: Role of adenosine[J]. Hepatology, 2002, 35(1): 167-175. DOI: 10.1053/jhep.2002.30425.
[19]	JO SK, CHA DR, CHO WY, et al. Inflammatory cytokines and lipopolysaccharide induce Fas-mediated apoptosis in renal tubular cells[J]. Nephron, 2002, 91(3): 406-415. DOI: 10.1159/000064280.
[20]	YAMAGUCHI N, JESMIN S, ZAEDI S, et al. Time-dependent expression of renal vaso-regulatory molecules in LPS-induced endotoxemia in rat[J]. Peptides, 2006, 27(9): 2258-2270. DOI: 10.1016/j.peptides.2006.03.025.
[21]	SANYAL AJ, BOYER T, GARCIA-TSAO G, et al. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome[J]. Gastroenterology, 2008, 134(5): 1360-1368. DOI: 10.1053/j.gastro.2008.02.014.
[22]	MOORE K, JAMIL K, VERLEGER K, et al. Real-world treatment patterns and outcomes using terlipressin in 203 patients with the hepatorenal syndrome[J]. Aliment Pharmacol Ther, 2020, 52(2): 351-358. DOI: 10.1111/apt.15836.
[23]	ALESSANDRIA C, OZDOGAN O, GUEVARA M, et al. MELD score and clinical type predict prognosis in hepatorenal syndrome: Relevance to liver transplantation[J]. Hepatology, 2005, 41(6): 1282-1289. DOI: 10.1002/hep.20687.
[24]	HEIDEMANN J, BARTELS C, BERSSENBRVGGE C, et al. Hepatorenal syndrome: Outcome of response to therapy and predictors of survival[J]. Gastroenterol Res Pract, 2015, 2015: 457613. DOI: 10.1155/2015/457613.
[25]	YIN W, LI CZ. Efficacy and prognosis of terlipressin for hepatorenal syndrome and its related factors[J]. Chin J Hepatol, 2016, 21(2): 100-104. DOI: 10.3969/j.issn.1008-1704.2016.02.005. 尹伟, 李成忠. 特利加压素治疗肝肾综合征的疗效、预后及相关影响因素[J]. 中华肝脏病杂志, 2016, 21(2): 100-104. DOI: 10.3969/j.issn.1008-1704.2016.02.005.
[26]	TAN J, TIAN X, HAN Z, et al. Efficacy comparison between noradrenalin and terlipressin in the treatment of hepatorenal syndrome[J]. Med J Wuhan Univ, 2016, 37(3): 485-487. DOI: 10.14188/j.1671-8852.2016.03.033. 谭洁, 田霞, 韩峥, 等. 去甲肾上腺素与特利加压素治疗肝肾综合征疗效比较[J]. 武汉大学学报(医学版), 2016, 37(3): 485-487. DOI: 10.14188/j.1671-8852.2016.03.033.
[27]	TAN YX, LONG FL, MAO DW, et al. Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome: A Meta-analysis[J]. J Clin Hepatol, 2019, 35(10): 2266-2271. DOI: 10.3969/j.issn.1001-5256.2019.10.027. 覃艳新, 龙富立, 毛德文, 等. 去甲肾上腺素或特利加压素联合白蛋白治疗1型肝肾综合征效果及安全性比较的Meta分析[J]. 临床肝胆病杂志, 2019, 35(10): 2266-2271. DOI: 10.3969/j.issn.1001-5256.2019.10.027.
[28]	ARORA V, MAIWALL R, RAJAN V, et al. Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure[J]. Hepatology, 2020, 71(2): 600-610. DOI: 10.1002/hep.30208.
[29]	CAVALLIN M, KAMATH PS, MERLI M, et al. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial[J]. Hepatology, 2015, 62(2): 567-574. DOI: 10.1002/hep.27709.
[30]	BRENSING KA, TEXTOR J, PERZ J, et al. Long term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant cirrhotics with hepatorenal syndrome: A phase Ⅱ study[J]. Gut, 2000, 47(2): 288-295. DOI: 10.1136/gut.47.2.288.
[31]	DENG D, LIAO MS, LUO KS, et al. Ultrasonographic study on renal hemodynamic changes after transjugular intrahepatic portosystemic stent shunt[J]. Chin J Ultrasound Med, 2004, 20(7): 524-527. DOI: 10.3969/j.issn.1002-0101.2004.07.014. 邓旦, 廖明松, 骆克枢, 等. TIPSS术后肾脏血流动力学改变的超声评价[J]. 中国超声医学杂志, 2004, 20(7): 524-527. DOI: 10.3969/j.issn.1002-0101.2004.07.014.
[32]	PEEYUSH T, SCOTT W, ROWENA C, et al. Reduced inpatient mortality with transjugular intrahepatic portosystemic shunt (TIPS) creation in cirrhotic patients admitted with hepatorenal syndrome[J]. JVIR, 2016, 27(3): S192. DOI: 10.1016/j.jvir.2015.12.496.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (516) PDF downloads(94)

Mechanism and treatment of portal-systemic circulatory imbalance in hepatorenal syndrome

DOI: 10.3969/j.issn.1001-5256.2021.12.006

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Mechanism and treatment of portal-systemic circulatory imbalance in hepatorenal syndrome

DOI: 10.3969/j.issn.1001-5256.2021.12.006

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content